农村地区慢性病管理的困境和成因分析  

Analysis on the current dilemma and cause of chronic disease management in rural China

作　　者：代宝珍[1] 

机构地区：[1]江苏大学管理学院,江苏镇江212013

出　　处：《中国公共卫生管理》2017年第4期472-475,共4页Chinese Journal of Public Health Management

基　　金：国家自然科学基金(71203080);中国博士后科学基金特别资助(2015T80520);江苏省"六大人才高峰"第十一批高层次人才项目(2014-JY-004)

摘　　要：慢性病已成为当今中国面临的重大公共卫生问题和社会问题。在农村地区,慢性病形势尤为严峻。通过知情人深入访谈、半结构焦点小组访谈等定性研究方法,旨在进一步探究和解释我国农村慢性病管理存在的问题。研究发现,我国农村居民慢性病患病率高、治疗率低;慢性病给农村居民及家庭带来了沉重的经济负担;农村居民慢性病预防与管理均不到位,且部门协同性差,慢性病管理效果亦差。进一步分析其原因发现,造成当前慢性病管理困境的主要原因有:慢性病管理资金补助不足,乡村医生数量不足、年龄老化和收入结构不合理,慢性病管理相关部门协同意识差等。对此,提出对策建议:(1)组建慢性病管理团队,改进慢性病管理考核指标;(2)建立部门协同机制,共享慢性病管理信息;(3)改善乡村医生收入结构,培育青年乡村医生队伍;(4)重视乡镇卫生院作用,抓住重点人群和管理环节。Chronic diseases are major public health problems and social problems faced by China. In China,the situation of chronic diseases in rural areas is much more serious than that in urban. By conducting in-depth key informant interviews and semi-structured focus group interviews,this study aims to further explore and explain the current situation of chronic disease management in rural China. The study results showed that the prevalence rates of chronic disease were high with low rate of treatment,there was a heavy burden brought by chronic diseases and a cute lack of prevention and management of chronic diseases among rural residents with poor health outcomes and low cooperation between public sections. Lack of financing and village doctors,the aging of village doctors and unreasonbeal income structure among them and poor cooperation consciousness were the main reasons which cause the chronic disease management dilemma in rural China. This study puts forward some countermeasures and suggestions as follows：（ 1） developing chronic disease management teams and improving the assessment indicators of chronic disease management;（ 2） establishing cooperation mechanism between public sections and sharing the chronic disease management information;（ 3） changing the income structure of village doctors and fostering young village doctors;（ 4） attaching importance to townships hospitals and focusing on the key points of chronic disease management and those population at high risk.

关 键 词：农村地区 慢性病 管理 基本公共卫生服务项目 新型农村合作医疗制度 定性研究方法 

分 类 号：R197.2[医药卫生—卫生事业管理]